Enhancing Analytical Thinking in Early-Career Physicians: Evaluating the EBM-CBL-PBL Integrated Teaching Model

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Abstract

Background Clinical reasoning is a critical skill in medical education. Dual-process theory highlights the interaction between intuitive and analytical thinking, where the former may lead to diagnostic errors. This study employed the cognitive reflection test (CRT) to assess cognitive reflection patterns across different experience levels and genders, while evaluating the impact of an integrated EBM-CBL-PBL teaching model on the development of analytical thinking in medical trainees. Methods A cross-sectional study was conducted among trainees, Resident Physicians, Attending Physicians and Consultant-level Physicians registered at the First Affiliated Hospital of Anhui University of Science and Technology. A generalized linear mixed model (GLMM) was used to analyse the relationships among sex, clinical experience, and analytical thinking. Participants comprising clinical medicine trainees were randomly allocated to either the traditional pedagogy group (n = 18) or the EBM-CBL-PBL intervention group (n = 18), with comparisons made on the basis of CRT responses (intuitive vs. reflective) and teaching satisfaction. Results Analytical thinking (CRT–Reflective) increased with increasing clinical experience (trainees: 41.18%, residents: 51.85%, attending physicians: 57.14%). Senior female physicians presented the strongest analytical tendency (OR = 5.919, p = 0.005). The EBM-CBL-PBL approach enhanced reflective cognition (61.11% vs. 44.44%, p < 0.05) and satisfaction (p < 0.001), but no significant gender interaction was observed (P = 0.396). Conclusion Clinical experience contributes to the development of analytical thinking, particularly among female physicians. The EBM-CBL-PBL teaching model improves analytical understanding in early-career physicians but does not eliminate gender differences. Sustained effects require long-term practice.

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